Provider Demographics
NPI:1275810798
Name:BLANCO, YVETTE
Entity Type:Individual
Prefix:MS
First Name:YVETTE
Middle Name:
Last Name:BLANCO
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:YVETTE
Other - Middle Name:
Other - Last Name:BLANCO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, ASW
Mailing Address - Street 1:1270 NATIVIDAD ROAD
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901
Mailing Address - Country:US
Mailing Address - Phone:831-796-1500
Mailing Address - Fax:831-757-3135
Practice Address - Street 1:951 BLANCO CIR STE B
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4451
Practice Address - Country:US
Practice Address - Phone:831-784-2150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-11
Last Update Date:2018-02-26
Deactivation Date:2013-07-15
Deactivation Code:
Reactivation Date:2014-05-20
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
CAASW81583101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor